Take the Stairs:Stair climbing to increase lifestyle physical activity

Introduction

Researchers from the University of Birmingham, led by Frank Eves from the School of Sport, Exercise and Rehabilitation Sciences, have been testing methods to encourage the increased use of stairs, rather than escalators and lifts, with the aim of increasing the number of calories burned during daily life.

Research objectives - what was the challenge?

Insufficient levels of physical activity are a major public health challenge. It is widely agreed that populations throughout the western world are insufficiently active for optimal health, and that low levels of physical activity are one factor in escalating rates of obesity.

During the 1990s, there was a change in strategy to address this problem of low levels of physical activity. Recommendations for formal sessions of vigorous exercise were replaced by guidelines targeting the accumulation of moderate intensity activity as part of daily living

Stair climbing expends more energy per minute than jogging, is readily available to most of the population, and the activity can be accumulated throughout the day as part of work, leisure and home life. The University’s research indicates that stair climbing interventions produce a 6.4% increase in usage of public access stairs, with a 12.3% increase recently reported in one workplace. Stair climbing represents a simple form of preventive medicine for weight gain. An average weight man for example, i.e. 80 kg, who climbs stairs in his home an extra ten times each day, accumulates energy expenditure equivalent to 3lbs of fat over a year. Over 10 years, this accumulation would be over 2 stone.

Research outputs - what was the process?

Dr Eves’ research uses ‘point-of-choice’ prompts which are messages displayed in the environment where a healthy choice can be made. These prompts took the form of signs located at strategic points to encourage people to use stairs instead of lifts or escalators if possible. The effects of poster size, message content and context for public access interventions were explored, as well as the use of messages fixed to the vertical riser of the stairs themselves. Effects of message specifically targeting heart health and weight control were tested in shopping centres, stations and workplaces.

Dr Eves designed and installed stair climbing interventions that changed employers’ practice in local authorities in Birmingham (2008, 2011), Coventry (2011), Walsall (2012), Dudley (2012), Nottingham (2013) and Worcester (2013), as well as Severn Trent (2008), the West Midlands police (2009), Pilkingtons (2011) and the Birmingham Chamber of Commerce (2011). A combined workforce of 6,650 was exposed to stair climbing campaigns over this period, as well as a significant number of uncounted visitors to the targeted buildings.

Research impact

Dr Eves was one of the first researchers to realise the potential public health dividend from increased stair climbing. His research contributed to the positive evidence reviews that allowed the Centres for Disease Control and Prevention (USA) in 2002 and the National Institute for Health and Clinical Excellence (UK) in 2008 to recommend use of prompts to increase stair climbing as a public health initiative. He has been advising the Department of Health (Catalunya, Spain) on their lifestyle physical activity strategy since 2005. Recently, his research contributed 46% of the evidence base for physical activity nudges submitted to the Department of Health (UK).

A published research study on these workplace interventions reported a 12.3% increase in stair climbing, demonstrating that such campaigns can change employees’ behaviour towards a health-enhancing alternative. This paper also prompted Unilever to request use of Dr Eves’ campaigns for their workforce nationally and internationally. In Nottingham, the public health department was alerted to Dr Eves’ research by academics in the national PA field. He modified a stair climbing campaign for Heart Research UK for use by National Car Parks Ltd (2010) that was used in Birmingham, Walsall, Stratford-upon-

Avon and Manchester, and currently being extended within the UK.

More broadly, this research has been picked up by individuals who are not directly involved in public health and the implementation of physical activity strategies, thus leading to the potential for even wider impacts. For example, his work has been used by staff of KLM Health services to write an article on the use stair climbing as a means of ‘designing the working environment to prevent health risks’ and a green architect’s collective as a means of reducing the carbon footprint of buildings. He was even asked by pupils at a US school for permission to use one of his stair climbing campaign in their school.